MEDICARE: SHANA NICOLE ADAMS PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	0010-10875	NC

General Provider Information

NPI Number	:	1154923795
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANA NICOLE ADAMS PA

Provider Business Mailing Address
First Line	:	5617 ALBEMARLE RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28212-3611
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5617 ALBEMARLE RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28212-3611
Country	:	US
Telephone Number	:	980-470-8642
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/09/2020
Last Update Date	:	03/31/2025

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Directions to “ SHANA NICOLE ADAMS PA” Practice Location

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